April 18, 2012
Hello everybody:
It's not about the money.
Much - I daresay most - of the talk surrounding health care in our country is focused on economics, on the dollars and cents of the issue. These discussions often have a cradle-to-grave quality, as health care bills usher us into this world (it costs a lot to have a baby), and end-of-life care expenses usher us out. In between are the countless expenses that make up a life, from doctor visit copays, to major and minor surgeries, to eye and dental expenses ... the list could go on ad infinitum.
The money discussion goes far beyond an individual's cost to see medical professionals, however. It includes everything from the revenues and profits of health care insurance companies to the costs of research, development and marketing of drugs; from the high cost of state-of-the-art medical technology to the billions of dollars in write-offs logged by hospitals whose emergency rooms are filled with those unable to pay; from funding for Medicare and Medicaid to the costs associated with medical liability insurance.
These conversations also must inevitably include the cost of a medical education, of the debt typically incurred by health professions students in all fields of care, and of the pressures they face upon graduation to find good-paying jobs.
Despite all that, again I say: It's not about the money.
This is not naiveté, nor is it an oversimplification. It's understood that money is inexorably tied to "health care" as a description of the mechanisms in place to facilitate treating patients. But finances should play no part in the willingness and commitment needed to provide that care in the first place, nor in the caliber of care, compassion, and technical expertise involved in treating patients well.
We do not look upon a suffering child and ask which insurance carrier she has, or how she will pay the bill for our treatment; instead, we simply strive for a way to make her well. We do not ask the senior, in pain from a lifetime of wear and tear on his muscles and joints, how much money he has in his wallet; instead, we use our knowledge and skill to ease his suffering.
The same holds true with regard to the cost, price, and value of a health professions education. Certainly, every health professions institution must look to control costs and minimize the financial impact on students as best it can. At the same time, it must not do anything to weaken the quality or integrity of its programs in an effort to make them less expensive. Those committed to serving others as health professionals do not ask to be taught how to do it cheaply so that they can go out into the world and make huge salaries. Instead, they ask to be educated on how to offer care completely and to the best of their abilities, that they might best serve their fellows.
As I have remarked in the past, to take on the calling of a healer suggests that one's motivation goes beyond simply expecting a high financial return on one's investment. The time and money invested in a health professions education yield a lifetime of benefits, both individually and to society at large. No price tag can truly be put on such an education, just as no price tag can be put on the needs of a patient or on a health-care provider's willingness and commitment to help.
Yes, solutions must be found on the financial side of the health care business. Whether it's the Affordable Care Act, Medicare reform, subsidized medical education, or something else entirely, new ways must be found to make it all pencil out. But politicians and government won't truly change health care. Health care professionals will, because it's the right thing to do for the patients they serve.
We can talk and argue about the dollars and cents all we want, but at the end of the day, it's not about the money. It's about a moral obligation that we have to care.
As always, I welcome your feedback on this topic and any others as we discuss WesternU's Benchmarks of Value, and our plans. Please e-mail me with your thoughts at ppumerantz@westernu.edu, and feel free to share this message with your family and friends.
My best to you all,
